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162 Citadel Road Lot 11Davie County, NC Tax Parcel Report Tuesday, November 15, 2016 WA1RN Nki: '1'RIIN IN NUT A SURVEY Parcel Information Parcel Number. F3010A0011 Township: Clarksville NCPIN Number. 5811820801 Municipality: Account Number: 82521555 Census Tract: 37059-801 Listed Owner 1: HENNE KENNETH Voting Precinct: CLARKSVILLE Mailing Address 1: 168 CITADEL RD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-4979 Voluntary Ag. District: No Legal Description: LOT 11 CHARLESTOWNE GRANT Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 1.78 Elementary School Zone: WILLIAM R DAVIE Deed Date: 4/2011 Middle School Zone: NORTH DAVIE Deed Book / Page: 008570504 Soil Types: MnC2,MnB2,MdD Plat Book: 0007 Flood Zone: Plat Page: 102 Watershed Overlay: DAVIE COUNTY Building Value: 0.00 Outbuilding & Extra Freatures Value: 0.00 Land Value: 30800.00 Total Market Value: 30800.00 Total Assessed Value: 30800.00 161 Davie County, NC All data Is provided as Is without warranty or guarantee of any ldnd either expressed or Implied Including but not limited to the Impliedwanan es of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmlessthe County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or inability to use the GIS data provided by this webWW V, 1 D DAVIE COUNTY ENVIRONMENTAL HEALTH �fr P.O. Box 848/210 Hospital Street s�d� Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990004313 Tax PIN/EH M 5811-82-0801 Billed To: Scott & Sheri Mayer Subdivision Info: Charleston Grant Lot # 11 Reference Name: Location/Address: Citadel Road -27028 Proposed Facility: Residence Property Size: 1.3 Acres ATC Number: 4657 Site Type:lelew ❑Repair ❑Expansion **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat or the intended use change. Residential Specifications: # Bedrooms # Bathrooms 7 # People Al Basement❑ Basement plumbinj,8' Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size i • Type of Water Supply: ottounty/City ❑ Well ❑ Community Well System Specifications: Design Wastewater Flow (GPD) 4� ank Size /CCQiAL. Pump Tank 1COC?3AL. Trench Width 5(� Max. Trench Depth 2$'r Rock DepthQ N Linear Ft. 4. -Hof Site Modifications/Conditi Pi ST06inina ZPyac!5 , 1 e+1:Lp , L- L->�J XON l q' ft R L S Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 — 9:30a.m. on the day of installation. Telephone # (336)751-8760. Environmental Health DCHD 11/06 (Revised) N� DAVIE COUNTY ENVIRONMENTAL, HEALTH P.O. Box 848/210 Hospital. Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 OPERATION PERMIT Account #: 990004313 Tax PIN/EH #: 5811-82-0801 Billed To: Scott & Sheri Mayer Subdivision Info: Charleston Grant Lot # 11 Reference Name: Location/Address: Citadel Road -27028 Proposed Facility: Residence Property Size: 1.3 Acres ATC Number: 4657 **NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC has been installed in compliance with Article 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any given period of time. System Type: S.T. Manufacturer Tank Date Tank Size Pump Tank Size System Installed By: DCHD 11/06 (Revised) E.H. Specialist: Date: Apr 05 07 02:00a p•2 �oATPL I N FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC ODavie County Environmental Health V P.O. Boz 6=10 Hospital Street /I A PQ� Mock sville, NC 27028 Wev J's I i eVat uak-A IL (336)751-876W Fxx (336)751-8786-• � $rtr carr Site EvaluatioMmptovement Permit Authorization To Construct(ATC) Bodl Be row i v lication: New System Repair to Existing System ExpansiontModification of Existing System or Facility i 'o V•••1MPORTANT""• THIS APPLICATION CANNOTBE PROCESSED UNLESS ALL OF THE REQUIRED b.K � INFORMATION IS PROVIDED. Referto the -INFORMATION BULLETIN for instructions. 4 "APPLICANT INFORMATION Name to be Billed 6 t o ff— A4Q er Contact Person Billing Address Home Phone 33 • - S' .•l- n City/State2lP �. Business Phone FV— Name on PermittATC if Different than Above Mailing Address City/State/Zip v PROPERTY 1NFORNLATION •DateHouse/Facility Comers Flaeeed i NOTE: A survey plat or site plan must accompany this application. included. Site Plan Plat(to scale) (Permit 6 valid for 60 months with site plan, no expiration with complete plat.) Otvner's Name Toe , 0. Phone Number Owner's Address 139 K I /e Wee--dPGu CitylState/Zip Property Address Lor' a_1 Cit�S_ �� %/,o Tax P1Nk)+'$Oi(7� , 3► Subdivision Name(ifal�plicahle)Seetitmitotit _u Directions To Site: L -/I/ Al. S, ate: - l 7,1 . LE •F�s- ,s.. L If the answer to any of the following questions is "Yes",supportin.- documentation must be amched." Are there any existing wastewater systems on the site? Yes No Does the site contain jurisdictional watlands? Yes rjp- Are there any casements or right-of-ways on tite site? Yes No Is the site subject to approval by another public agency? Yes Xe %V,11 v:ailvt42'iCr Out Jr than doth ,tic stwege be =cnerated^, Yes N6 IF RESIDENCE FiLL OUT THE BOX BELOW ZA # People 11 # Bedrooms Bathrooms - Gardett TubA Vhirtpool Yes o Basernent: m Yes 1 No Baseent Ptumbine es No iF NON-RESiD1ENCE FILL OLT THE BOX BELOW 1} -pc of Facility/Business Total Square Footage of Building # People # Sinks P Commodes # Showers # Urinals Estimated Water Usage (gallons per day) (Attach documentation ofsimilar facilin• water consumption) FOODSERVICE ONLY: # Seats Type system roquested. &e6nvenwrial Accepted Innovative Alternative Other Water Supply Type: Q66ty/City Water New Well Existing Well Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? Yes No If yes, what type? This is to certify, that the inrarmatiorr provided on this application is true and correct to the best of my knowledge. 1 understaad that any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if the information submitted in this application is falsified or Chan -.ed. I hereby grant right of entry to the Authorized Representative ofthe Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that t am responsible for the proper identification and labeling of property lines and corners and locating a d flaggin r sulking the houselfacility location, proposed well location and the location of any other amenities. aAJ i Site Revisit Charge Pr�Owner's or owns s at representative signature Client Client): CNotification Date: Date EHS: Sign given ' � Yes No Account Revised 11106 - Invuice k _�e 1 Apr 05 07 02:00a /a C - ;tt, /W go � -, p.3 APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental f/eaith Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 ***ZWORTANT"** THIS APPLICATION CANNOT EE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed ��/ �,e CL Contact Person J).4,-) 609REL.L- Mailing Address 93 2 /04TLE DGE ei> �y Home Phone 4 / Z '-5-O City/State/ZIP /�OGKSd/LLE, /1�C— 2_ -71V 3, Business Phone .4qZ —S4-4 a 2. Name on Permit/ASC if Different than Above Mailing Address City/state/Zip 3. Application For: X Site Evaluation ❑ Improvement Permit/ATC ❑ Both 4. system to service: XN House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms # Bathrooms fl Dishwasher II Garbage Disposal IJ Washing Machine I] Basement/Plumbing IJ Basement/No Plumbing 6. If Business/Industry/other: specify type # People # sinks # Commodes # showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated water Usage (gallons per day) 7. Type of water supply: County/City 0 well U Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 'Kft If yes, what type? 'IMPORTANT" CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBAIITTED by the client with THIS APPLICATION. Property Dimensions: A ' / ��// _ _� J�45 / E DIRECTIONS (from Mocksville) to PROPERTY: Ta: Office PIN: # �j 4o eD WA ..)) E o I nl L/��ia�ti ��N Property Address: Road Name WACWr2 Z/{ D g, SFT o� Li13F�'M So 4A1 ILA?- city/zip •LKsdr�c.E 2- 7a 2 T,P.,J GEFr oy G✓/fGAle,2 Z5 If in a Subdivision provide information, as follows: pp Name: 2n - --_— 1.i�4RL�TLtiJ(�PAP►T G�ec /0 Section: Block: Lot: I I D /! v• 0 MAIP This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified or changed I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Authorized Representative of theDevic Count Health Department to enter upon above described property located in Davie County and owned by ZP tZ. to conduct all testing procedures as necessary to determine the site suitability. Vol DATE " �d SIGNATURE i /� DAVIE COUNTY HEALTH DEPARTMENT /! Environmental Health Section SECTION LOT > Soil/Site Evaluation APPLICANT'S NAME � ' PROPOSED FACILITY ofoo SUBDIVISION f t_ ACG Water Supply: On -Site Well Community, Evaluaiion By: Auger Boring Pit_ DATE EVALUATED 10b h -W PROPERTY SIZE 7D )Oe x 4---A' x2X0 f OJ ROAD NAME W A&VOOL 09 Public Cut FACTORS 1 - 2 3 4 5 6 7 Landscape position - L L L' Slo e % 170 4 HORIZON I DEPTH - 0-/0 O ,- r - Texture group T i- ej Consistence jcr - ,- SS.,r S55tv Structure 2 021 Mineralogy1 I 7 5V A HORIZON II DEPTH Texture group e__ Consistence Structure L k 1-15t lake Mineralogy( . HORIZON III DEPTH - w _D - 3 f - Texture group Consistence 5 P F 19�SIP fr Structure C S Mineralogy - 1 HORIZON IV DEPTH 4 Texture group Consistence Structure ITLUS Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE - CLASSIFICATION LONG-TERM ACCEPTANCE RATE J- 7> ' 7 SITE CLASSIFICATION: PS LONG-TERM ACCEPTANCE RATE: 01 REMARKS: `N3 STiALI- Sy ST, - 0,, V EVALUATION BY: OTHER(S) PRESENT: LEGEND Landscape Position R - Ridge S - Shoulder L - Linear slope FS - Foot slope Ne CC - Concave slope CV - Convex slope T - Terrace FP - Flood plain -_7,W., t A,:r4 Li 32" 4- A- S P H - Head slope Texture S - Sand LS - Loamy sand SL - Sandy loam L - Loam SI - Silt SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam SC - Sandy clay SIC - Silty clay C - Clay CONSISTENCE Moist VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm Wet NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky __NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic Structure SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangular blocky PL - Platy PR - Prismatic Mineralogy 1:1, 2:1, Mixed Notes Horizon depth - In inches Depth of fill - In inches Restrictive horizon - Thickness and inches from land surface Saprolite - S(suitable), U(unsuitable) Soil wetness - Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less Classification - S(suitable), PS(provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - gal/day/ft2 ._ DCHD(01-90) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■/■■■/■■■■■■//■ �ni�t��c:.;rr�/ri��tr�/ii�ii/iiii.ii ■■■■■■■■■■■■■■■■■■■►'�■■■■■■■ill■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■E■ MEMO■ ■ ■E■E■E■■■■■ ■■EE■■■EE■■ ■EEE■EEE■■■ ■■■■■E■E■■■ ■■■■■■EEE■■ ■■■Mm.: -.EE■ ■omambr.M■EM ■ LOT #10 ti r� C) 10 - AREAr 2.704 ACRES iQi p AA ' C10 �o . 43' 52: N 5og,90 v y LOT v AREA= 1.801 ACRES Q _w �o w I-- r 'o `D -� ( , 467.8 0 0 Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/Fax(336)751-8786 IMPROVEMENT PERMIT Account #: 990004313 Billed To: Scott & Sheri Mayer Address: 6075 Habersham Drive City: Kernersville Reference Name: Tax PIN/EH M 5811-82-0801 Subdivision Info: Charleston Grant Lot # 11 Location/Address: Citadel Road -27028 Property Size: 1.3 Acres Prop o *ed i*iter Residence N f This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type: /New ❑Repair ❑Expansion Permit Valid for: 0 Years ,Ao Expiration Residential Specifications: # Bedrooms—4—# Bathrooms # People 4 Basement Basement plumbin;ie Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): `/80 Type of Water Supply: K1 ounty/City ❑Well ❑CommunityWell Site Modifications/Permit Conditions: Nap 2cool as--� S stem Type LTAR Initial — 1E7 C). L7-5 Repair -b Site Plan Specialist i.p.1 l-06 is